Indian Journal of Trauma and Emergency Pediatrics

Objective: To review the role of non operative management in paediatric Grade V renal trauma case and importance of placement of ureteral stent. Case Presentation: 9 year old male child presented with h/o fall from height sustaining injury over the right side of abdomen. On examination he had abdominal tenderness, tachychardia with B.P. 100/60 mm of Hg. CT-Angiography showed grade V upper polar renal vascular injury with complete shearing of the upper pole of the right kidney with urinary extravasation. Patient was managed conservatively with bed rest, intravenous fluids and underwent DJ stenting. After one month of injury, repeat CT angio showed no urinary extravasation with intact renal parenchymal architecture and good functioning lower pole of the right kidney. Conclusion: Non operative management is possible in selected cases in children with Grade V renal trauma patients. Patients with increasing urinary extravasation can be salvaged with ureteral stents. 

Key words: Paediatric; Urinary extravasation; Non- perative; Ureteral stent. 

End-tidal carbon dioxide monitoring is useful in the prehospital setting, emergency department, intensive care unit, and operating room. Monitoring capnography/capnometry is the single most useful method and is recommended to confirm proper endotracheal tube position. It has a variety of clinical applications in critically ill pediatric patients. 

Key words:Capnograhy; Pediatric; Emergency;Uses.
 

Seizures are one of the common symptoms seen in preterm infants. It occurs in 6% to 13% of very low birth weight infants, and in 1to 2 per 1,000 of infants born at term [1, 2, 3]. Sonography of the brain also known as neurosonogram is proved diagnostic modality to evaluate intracranial abnormalities [4 -8]. It is very sensitive in picking intracranial pathologies like haemorrhage (intracranial, intraventricular and subependymal), ischemia, hydrocephalus [9, 10], and congenital abnormalities. In our hospital all the preterm infants are scanned for abnormality in brain by sonography as they can be missed on clinical evaluation. In our study intraventricular bleed was the most common abnormality detected. 

Keywords: Neurosonography; Preterm infant; Seizure. 

Objectives: To study the incidence, aetiology, and outcome of non-traumatic coma in children. Materials and Methods: 100 consecutive cases of non-traumatic coma between 6 months and 15 years of age were selected for the study. Aetiology of coma is determined on the basis of clinical history, examination, and relevant laboratory investigations by the treating physician. These children were followed up till they discharged from the hospital. Results: A total of 100 cases of children admitted to the hospital with Non- raumatic coma was included in the study. Majority of the children were in the age group of 1-5yrs (41%), males were slightly more affected than females. Mortality was high in the age group of 1-5 yrs. CNS infections accounted for 70% of cases . Toxic/Metabolic group constituted 19% of cases, followed by other causes. Mortality was high in children with intracranial space occupying lesions and intracranial bleeds.CNS infections had slightly better survivals as compared to toxic/metabolic and IC bleeds. Conclusion: Acute non-traumatic coma is one of the most common pediatric emergencies, which arouses much anxiety and apprehension in both parents and physicians. Due to heterogeneity of causes in these patients , prediction of outcome is difficult and unfortunately no single clinical, laboratory or electrophysiological parameters singly predicts their outcome. We have attempted to delineate neurological signs to predict the prognosis in this study. 

Keywords: CNS infections; Non- raumatic coma; Intracranial bleeds; Mortality.